Prediction and prevention of swallowing dysfunction after curative (chemo)-radiation in head and neck cancer
The aim of the first part of the project was to determine which factors, including the dose distributions in swallowing organs at risk (SWALSTRUCTs) predict post-treatment swallowing dysfunction. The plan was to perform a prospective cohort study in which 240 patients had to be included. Dose volume histograms (DVH’s) of the SWALSTRUCTs and other potential determinants, as well as a number of objective (e.g. videofluoroscopy (VF)) and subjective measures of swallowing dysfunction will be assessed before, during and after treatment. Based on the findings of this study, a predictive model will be developed and subsequently validated in a second cohort of patients. We planned to include 240 patients in the prospective cohort study (STAP) and 144 patients in the prospective study (invasive part) including also VF and CT (SWAP) to assess the patho-physiological mechanisms of swallowing problems and to provide information for the prospective swallowing exercise program (PSEP).
Part 2 of this project aims to develop preventive strategies: swallowing sparing IMRT and a preventive exercise program.
The predictive model will be used to define which anatomical structures should be considered relevant Swallowing Organs at Risk (SWAOARs) and which dose constraints for the SWOAR’s should be used for in swallowing sparing IMRT (SS-IMRT). SS-IMRT will be developed by using these dose constraints and the SS-IMRT plans will be compared to the standard IMRT plans to estimate the potential benefit of this new technique on the individual as well as the group level. Based on this planning comparative study, we will develop a new radiation protocol that will be validated in PART 3.
The findings obtained by VF will be used to develop a Preventive Swallowing Exercise Program (PSEP) for those subjects that remain at high risk for swallowing dysfunction.
In the last part of the study, the potential benefit of SS-IMRT will be tested in a prospective cohort study.
Funding
Dutch Cancer Society (KWF Kankerbestrijding), 2008-2012.
Staff
PhD students
M. Christianen, MD, UMCG
K. Wopken, MD, UMCG
M.J. de Bruijn, MA, Linguist, VUmc.
Project leaders
Prof J.A. Langendijk, PhD MD, Radiotherapist-oncologist, dpt. Radiotherapy, University Medical Center Groningen (UMCG)
Prof I.M. Verdonck-de Leeuw, PhD, Psychologist, Speech and Language Therapist, Linguïst, dpt. Otolaryngology-Head&Neck Surgery, VUmc.
Project members
Members of the Head and Neck Cancer Working Groups of UMCG and VUmc.
Questions?
For questions, please contact:
Prof J.A. Langendijk, PhD MD, Radiotherapist-oncologist, dpt. Radiotherapy, University Medical Center Groningen (UMCG)
Email: j.a.langendijk@umcg.nl
or
Prof I.M. Verdonck-de Leeuw, PhD, Psychologist, Speech and Language Therapist, Linguïst, dpt. Otolaryngology-Head&Neck Surgery, VUmc.
Email: im.verdonck@vumc.nl
News flashes
12 april 2013: KWF Kankerbestrijding / Alpe d’HuZes has granted the research proposal Netherlands Quality of life and Biomedical Cohort Studies in Cancer (NET-QUBIC).
Marieke de Bruijn will defend her PhD thesis on 10 juni 2013 at 15.45 pm.
Support our bicycle team for Alpe d'HuZes 2013!
On 6 June 2013 our team living together with cancer will cycle the Alpe d'HuZes! This in the fight against cancer. At this moment there is already more than 1500 euro donated. Do you support us too?
The 15th World Congress of Psycho-Oncology and Psychosocial Academy will be held in Rotterdam, 4-8 November 2013. www.ipos-society.org/ipos2013/.
29 January 2013. Pink Ribbon has granted a project to develop and evaluate an online training for cancer patients with insomnia (Annemieke van Straten), and a project to develop and evaluate a breast cancer module for the OncoKompas (Nelly van Uden).
Charity Symposium "Living with cancer"
On December 19, 2012 there will be a Symposium ''Living with Cancer''. This is a charity symposium on meaning centered psychotherapy for cancer patients. Read more about it at the tab News at the left.
15 November 2012: Hoe?Zo! Radio interview with Irma Verdonck on stress and cancer.
October 2012: Interview with Irma Verdonck in Psychologie Magazine.
September 9, 2012. Interview Hans van Willigenburg with Irma Verdonck on Radio 5.
August 2012. Five students finish their MSc thesis and graduate as MSc in Clinical PSychology.
June 28-30, 2012: International symposium on Supportive Care in Cancer (MASCC ISOO) at New York. Kevin Yap and Irma Verdonck organise a workshop on e-health and supportive care.
Record for Alpe d'HuZes 2012. The sponsor action Alpe d'HuZes (6 and 7 June) 2012 has already yielded the record amount of 28.5 million euros.
June 6-8, 2012: Our research group contributes to Alpe d'HuZes as volunteers.
April 20, 2012: Nelly van Uden will give a presentation about OncoKompas at a conference about ICT in health care in Barcelona.
March 16, 2012: NVPO congress in Utrecht, we contribute with 2 oral and 2 poster presentations and a workshop.
January 1, 2012: The project POLARIS project has officially started.
December 22, 2011: Radio program DeGids.fm, Felix Meurders interviews Corien Eeltink on sexuality and cancer.
November 2, 2011: KWF / Alpe d'HuZes funds a grant for the development and evaluation of an online intervention for informal caregivers of cancer patients.
October 30, 2011 In the national television program "Gesprek op 2", Daphne Bunskoek interviewed Irma Verdonck on living with cancer.
October 28, 2011: www.oncokompas.nl is online!
October 23, 2011: Alpe d'HuZes hands over more than 20 million euros to the Dutch Cancer Society!
Team work
Our research projects are embedded in the two largest research institutes of VU University in Amsterdam: VUmc CCA-VICI (Cancer Center Amsterdam) www.vumc.nl/afdelingen/CCA-V-ICI/ and EMGO+ (Institute for Health and Care Research emgo.nl
We work closely with patients and their caregivers and with researchers and physicians at VU University and VU University Medical Center in Amsterdam and other research institutes and hospitals in the Netherlands and worldwide. Team work is crucial improving research and translating results into clinical practice.
